These people commenting about how you’re doing things wrong clearly don’t understand that this is for studying for the psychomotor assessment to pass the NREMT exam!! Smh. Thank you for these videos, they are very helpful!
This video is helpful and spot on with the NREMT sheet. To all those who are complaining about this comes before that, they are going by the sheet not real life scenario. I am renewing my EMT cert this week and our instructor told us this is how it is. Thanks guys.P.S. this video was made in 2017 so for those who are needing to recert soon there are some small changes to this assessment and other.
The “good shit” at the end was awesome! Great work! Even the “brain fart” remembering the secondary assessment shows how having those skill sheets down, will save you on test day. ...and no way will coffee girl spoil the day!!
Thank you for posting. Please pass it along and tell others!!!! Always looking for more subscribers too. This was never a pubic page until recently. I'm so glad it's helping people around the country! RallypointEMS\Jeremiah
Great assessment I’ve taken a lot of things you said to implement in my own assessment. However, I have some constructive criticism. When checking Circulation Sensory and Motor functions during the Lower & Upper extremity assessment it’s advantageous to compare the distal pulses to the opposite extremity. Additionally, when palpating the extremities, say the thigh, its advantageous to place your hands diagonal from each other, push and feel then switch from left top and right bottom to left bottom right top. That can be done to the thighs, calves, bicep region, and forearms.
You have to follow the order of the NREMT Trauma Assessment sheet. Don't confuse the order of operations here with the CPR/AED or Apneic Patient stations. Rallypoint EMS/Jeremiah
THAT IS INCORRECT! YOU MUST ALWAYS CHECK YOUR ABCS BEFORE MOVING ON UNLESS IMMEDIATE LIFE THREATENING BLEEDING IS APPARENT OR OTHER IMMEDIATE THREATS TO LIFE ARE VISIBLE.
ALSO HOW DO YOU KNOW THE PATIENT IS NOT IN CARDIAC ARREST OR APNEIC WITHOUT CHECKING FOR A PULSE OR BREATHING SO YOUR ARGUMENT MAKES NO SENSE. IF YOU ARE AN INSTRUCTIONAL YOU SHOULDN'T GLAZE OVER STEPS LIKE THIS
Do you have the sheet in front of you? If not, grab it, look over it and redo this video. ABC's comes RIGHT after the life threats and level of consciousness. You're wrong. "You have to follow the order of the NREMT trauma assessment sheet". That's correct, and the way this was done IS WRONG.
Rallypoint EMS NREMT Demos I don't think that's the case... I was always taught that you always check for ABC's after verbal and painful stimuli don't work unless you see life-threatening bleeding, in which case you treat that first.
I understand you are following the NREMT skillsheet however if this was a real life scenario your patient probably died because you failed to immediately check for an exit wound after treating the GSW to the chest.
Hi Baker. This isn't a real-life scenario though so we are not considering that. Every GSW is different. I've had many with no exit wounds. I've had a few that have exited. If it exits out the lower leg what are your considerations? Do you need a four-sided occlusive or do you just bandage it? Remember, every call is different. I had a patient who was shot with a 45 in the abdomen and the bullet ended up logged in his lower jaw. It wasn't noticeable to us or other providers on scene. Do a good assessment, manage any life threats and monitor and address the ABC;s. Worry about the rest later. RallypointEMS\Jeremiah
If you chart “entrance” or “exit” even if you are certain, instead of “open wounds” one of these days you may get called into court and asked how you knew for certain. Something like that could get a bad guy released or an innocent person incarcerated. Unless you have a degree in pathology, projectile dynamics or are board certified in forensic science, you should not chart those terms.
Agreed. Still should check for an exit even in training. Anyone knows relying on what you have seen before can get you fucked. Every call is different, so check all your bases.
Only not correcting any life threatening injuries, protecting the airway airway and transporting at the appropriating time is critical fails on this station.
WRONG CRITICAL FAILS ALSO INCLUDE NOT STABILIZING C-SPINE, NOT CHECKING YOUR ABCS (WHICH HE DIDNT DO), AND NOT FOLLOWING THE ORDER OF THE EXAM WHICH WOULD PROLONG YOUR ON SCENE TIME AND BE A CRITICAL FAIL SO......
Shouldn't stabilizing C-spine be done right after requesting ALS? And shouldn't back boarding and transport be done after the calculated GCS? I have my practical test this week and Im so confused on how to do this because we have been taught that for the test you have to follow word for word on the sheet for it? I really do enjoy your site, it has really helped me with studying.
Hi! Yes manual c-spine immobilization is done right after requesting ALS. I believe I had my partner do it in the video. Technically, you would board and transport the patient after determining your GCS. In the video I verbalize my rapid transport by saying my patient is a "high priority transport based on a GCS of three" at the 3 min 05 sec mark. That is sufficient enough you don't have to get nuts with packaging your patient. I want to see my students do the trauma skill station, not mess around with the backboard. Did you know there is actually a backboarding skill station? One thing to keep in mind is that you are being graded on your ability to perform this whole skill. I doesn't make sense to strap the patient to the board and then later try to check his back while he's strapped to the backboard. (We don't keep patient's strapped to backboards during transport anyway because they do more harm to the spine than good.) You absolutely do not need to follow the sheet word for word. We don't want you to be robots! This isn't realistic anyway because different scenarios and injuries are going to require you to do things a little differently. Even though we may do it a little differently, I recommend you perform the skill as you have practiced in class. I'm sure you'll do just fine. Nervous is good, it means you want it! So be confident and go get it! Thanks for watching! Rallypoint EMS/Jeremiah
National Registry of Emergency Medical Technicians Advanced Level Psychomotor Examination PATIENT ASSESSMENT - TRAUMA Candidate: ___________________________________________________________ Examiner: __________________________________________________ Date: ________________________________________________________________ Signature: __________________________________________________ Scenario # __________ Actual Time Started: __________ NOTE: Areas denoted by “**” may be integrated within sequence of primary survey Takes or verbalizes appropriate PPE precautions 1 SCENE SIZE-UP Determines the scene/situation is safe 1 Determines the mechanism of injury/nature of illness 1 Determines the number of patients 1 Requests additional help if necessary 1 Considers stabilization of spine 1 PRIMARY SURVEY/RESUSCITATION Verbalizes general impression of the patient 1 Determines responsiveness/level of consciousness 1 Determines chief complaint/apparent life-threats 1 Airway -Opens and assesses airway (1 point) -Inserts adjunct as indicated (1 point) 2 Breathing -Assess breathing (1 point) -Assures adequate ventilation (1 point) 4 -Initiates appropriate oxygen therapy (1 point) -Manages any injury which may compromise breathing/ventilation (1 point) Circulation -Checks pulse (1point) -Assess skin [either skin color, temperature, or condition] (1 point) 4 -Assesses for and controls major bleeding if present (1 point) -Initiates shock management (1 point) Identifies priority patients/makes transport decision based upon calculated GCS 1 HISTORY TAKING Obtains, or directs assistant to obtain, baseline vital signs 1 Attempts to obtain SAMPLE history 1 SECONDARY ASSESSMENT Head -Inspects mouth**, nose**, and assesses facial area (1 point) -Inspects and palpates scalp and ears (1 point) 3 -Assesses eyes for PERRL** (1 point) Neck** -Checks position of trachea (1 point) -Checks jugular veins (1 point) 3 -Palpates cervical spine (1 point) Chest** -Inspects chest (1 point) -Palpates chest (1 point) 3 -Auscultates chest (1 point) Abdomen/pelvis** -Inspects and palpates abdomen (1 point) -Assesses pelvis (1 point) 3 -Verbalizes assessment of genitalia/perineum as needed (1 point) Lower extremities** -Inspects, palpates, and assesses motor, sensory, and distal circulatory functions (1 point/leg) 2 Upper extremities -Inspects, palpates, and assesses motor, sensory, and distal circulatory functions (1 point/arm) 2 Posterior thorax, lumbar, and buttocks** -Inspects and palpates posterior thorax (1 point) 2 -Inspects and palpates lumbar and buttocks area (1 point) Manages secondary injuries and wounds appropriately 1 Reassesses patient 1 Actual Time Ended: __________ TOTAL 42 CRITICAL CRITERIA ____ Failure to initiate or call for transport of the patient within 10 minute time limit ____ Failure to take or verbalize appropriate PPE precautions ____ Failure to determine scene safety ____ Failure to assess for and provide spinal protection when indicated ____ Failure to voice and ultimately provide high concentration of oxygen ____ Failure to assess/provide adequate ventilation ____ Failure to find or appropriately manage problems associated with airway, breathing, hemorrhage or shock [hypoperfusion] ____ Failure to differentiate patient’s need for immediate transportation versus continued assessment/treatment at the scene ____ Does other detailed history or physical exam before assessing/treating threats to airway, breathing, and circulation ____ Failure to manage the patient as a competent EMT ____ Exhibits unacceptable affect with patient or other personnel ____ Uses or orders a dangerous or inappropriate intervention You must factually document your rationale for checking any of the above critical items on the reverse side of this form
Yes, you have to address apparent life threats first. This is a slight exaggeration, but if the dude was on fire, would anything else on the sheet matter? You wouldn't be worried about his airway you would want to put the fire out. Same deal with other life-threats. If he's bleeding out from an artery you want to fix that first then worry about his breathing.
THE LIFE THREAT WASN'T APPARENT UNTIL YOU CONTINUE WITH YOUR HEAD TO TOE WHICH IS IN THE SECONDARY ASSESSMENT. YOUR PRIMARY ASSESSMENT IF DONE CORRECTLY WOULD HAVE INSPECTED THE AIRWAY AND BREATHING WITH WOULD HAVE SHOWN DIMINISHED LUNGS ON ONE SIDE OR NO BREATHING OR PARADOXICAL MOTION OR EVEN JVD WHICH WOULD THEN FORMULATE YOUR DIFFERENTIAL DIAGNOSIS YOU WOULD USE TO POINT YOU INTO THE DIRECTION OF INSPECTION OF THE CHEST AND UNCOVER THE TRAUMATIC PNEUMOTHORAX. THIS WOULD ONLY BE A LIFE THREAT YOU WOULD CHECK FIRST IF YOU SAY FLAIL SEGMENT THROUGH THE SHIRT OR AN AMOUNT OF BLOOD LOSS OUTSIDE THE BODY THAT DOESN'T SUPPORT LIFE. DO NOT MISINFORM FUTURE HEALTHCARE PROVIDERS THAT MAY ONE DAY HAVE SOMEONES LIFE IN THEIR HANDS
Jordan Parton....to be clear, you’re telling me a sucking chest wound is not an apparent life threat? Last time I checked it was. If I find a hole in the chest I’m going to treat it immediately so that it does not progress into a tension pneumothorax. (As a reminder, tracheal deviation and JVD are ominous and late signs.). The purpose of the primary assessment is to identify and treat immediate life threats. This is exactly what was depicted in the video. Similarly, if the EMT were to discover an arterial bleed it would be managed right away. They wouldn’t wait until they checked the extremities during the “secondary assessment.” I appreciate your feedback, but my video and remarks are not misleading. Let me know if you need me to cite additional sources. www.emsreference.com/articles/article/tension-pneumothorax-0 books.google.com/books?id=UqEuDwAAQBAJ&pg=PA1801&lpg=PA1801&dq=jvd+is+a+late+sign&source=bl&ots=gyVDAoCDFn&sig=fOzNh-e71kdkkOwWx7-EShpI8zI&hl=en&sa=X&ved=2ahUKEwjs86r15IbbAhUBON8KHdLuAKMQ6AEwCHoECAQQAQ#v=onepage&q=jvd%20is%20a%20late%20sign&f=false www.sjgov.org/ems/pdf/policies/5504_bls_primary_patient_assessment_draft.pdf quizlet.com/62167023/emt-chapter-11-the-primary-assessment-flash-cards/ www.armystudyguide.com/content/powerpoint/First_Aid_Presentations/apply-a-dressing-to-an-op-5.shtml emt.emszone.com/docs/CH27_AEC_Table.pdf
Sucking chest wound would be and I stated that in my comment. My statement is that you bypassed ABC! you wouldn't notice a "Sucking chest wound" without inspecting under the clothes which in real life could be getting you pt trauma naked which you wouldn't do until after checking ABCs. Instead of being an arrogant EMT take advise from the multiple experienced MEDICS and Helivac RNs trying to inform you that you are and will continue to be wrong with this I know everything because I make videos attitude.
Rallypoint EMS NREMT Demos you know what good luck sir on your journey into ems. I’ll just make sure I’m I don’t get hurt or heaven forbid choke on something if I’m ever in your agency’s district. Again Good luck to you and all your patients 👍🏼
Very interesting to watch the American version. Some things I’d do in a different order but I haven’t looked at the skills assessment sheet but do get every service, certifying company and instructor has a way you need to follow during testing. Like most things the stuff we learn on the road or with further training adopts to our regular patient assessment and routine that doesn’t lean to far off the path but close enough to make more efficient for us as the responder. Now this was done in 2017, not to sure if the laws have changed for our friends down south regarding boarding and other tools we use on the road. If it did, would be interested in seeing how it changed for American standards. Regardless cool video. As this is training though and a video, I get why there wasn’t as much in depth of some of the tasks. Maybe next time set up the lifepac (if you have them) if it’s part of the curriculum, or strap them in to the board. It lets others that haven’t seen it or look for that to see it right. Otherwise nice video! Keep it up
Wait how is he putting the cervical collar after he load and go???? Asking for a friend Edit he didn't place him on a long board to transport ????? Ps no disrespect I am really nervous for my exams checking everything to the T
just because its currently patent doesnt mean the tongue wont move and block the airway. the the opa prevents that from happening especially with ventilations.
I believe only if he has a punctured lung that forces air into the pleural space. And the occlusive dressing is used to have any extra air leak out of the open side.
The 3 sided occlusive dressing acts as a flutter valve. It allows for the positive pressure air via BVM to escape that chest cavity but on exhalation the valve seals itself not letting any air get sucked in with the negative pressure. Normally its negative pressure on inhale and positive on exhale, but with an open chest wound the roles swap. Therefore to answer your question, no it wouldn't cause a tension pneumothorax as the three sided occlusive dressing is preventing that from happening.
Maybe this isn't on the skill sheet, but in a real life situation you would want to roll the patient and check for an exit wound right away, because why would you let him sit there with a possible second hole in his chest until the end of your secondary assessment.
Hey, qusai alrwashdeh, he mentioned that he would send his partner for Sample History, he called out transport priority along with a GCS of 3 and he log rolled to check the back then place the patient on the backboard. I want to say he hit all the points you mentioned; but, let me know if I may have misunderstood your comment.
In the field you may do things in a different order based on the presentation of your patient but every point he hit from the nremt trauma skill sheet you will hit in the field
Currently in EMT school. We are going over our NREMT sheets right now going through the steps..this is very helpful!! Thanks so much for this!
These people commenting about how you’re doing things wrong clearly don’t understand that this is for studying for the psychomotor assessment to pass the NREMT exam!! Smh. Thank you for these videos, they are very helpful!
He kinda is doing stuff irregularity tho and spending way to much time doing certain assessments
He also didn’t check for exit wound in the rapid which you’re supposed to do but I mean other than he I think he did really well
I'm currently in an EMT-R course and this video was very helpful. I can see I have a lot of practicing to accomplish. Thank you so very much.
This video is helpful and spot on with the NREMT sheet. To all those who are complaining about this comes before that, they are going by the sheet not real life scenario. I am renewing my EMT cert this week and our instructor told us this is how it is. Thanks guys.P.S. this video was made in 2017 so for those who are needing to recert soon there are some small changes to this assessment and other.
The “good shit” at the end was awesome! Great work! Even the “brain fart” remembering the secondary assessment shows how having those skill sheets down, will save you on test day. ...and no way will coffee girl spoil the day!!
Currently in emt-b class and I've watched this video a couple of times. Final skills are in a month and this has been a great help. thank you
Very thorough and helpful. This guy knows what he’s doing. Thank you for the upload.
I've literally probably have watched this video legit over 50 times 😂 my exam is on Friday
good luck mine is the 22nd! tell me how you do
How did it go? Was it hard?
Did you pass
I think I did 100 it’s the best one on yt
Me too!
By far my most watched assessment, use this to refresh all the time!
Thank you for posting. Please pass it along and tell others!!!! Always looking for more subscribers too. This was never a pubic page until recently. I'm so glad it's helping people around the country!
RallypointEMS\Jeremiah
Great assessment I’ve taken a lot of things you said to implement in my own assessment. However, I have some constructive criticism. When checking Circulation Sensory and Motor functions during the Lower & Upper extremity assessment it’s advantageous to compare the distal pulses to the opposite extremity. Additionally, when palpating the extremities, say the thigh, its advantageous to place your hands diagonal from each other, push and feel then switch from left top and right bottom to left bottom right top. That can be done to the thighs, calves, bicep region, and forearms.
Emphasis on checking their pedal pulses simultaneously to compare their quality and regularity.
Thank you for the videos EMT IS ODDLY FUN TO LEARN 4weeks in
Cant thank you enough for these videos
You guys are great. Thanks for making it clear and simple.
No disrespect intended, but why wasn't a carotid pulse & breathing assessed immediately following unresponsiveness to verbal or painful stimulus?
You have to follow the order of the NREMT Trauma Assessment sheet. Don't confuse the order of operations here with the CPR/AED or Apneic Patient stations.
Rallypoint EMS/Jeremiah
THAT IS INCORRECT! YOU MUST ALWAYS CHECK YOUR ABCS BEFORE MOVING ON UNLESS IMMEDIATE LIFE THREATENING BLEEDING IS APPARENT OR OTHER IMMEDIATE THREATS TO LIFE ARE VISIBLE.
ALSO HOW DO YOU KNOW THE PATIENT IS NOT IN CARDIAC ARREST OR APNEIC WITHOUT CHECKING FOR A PULSE OR BREATHING SO YOUR ARGUMENT MAKES NO SENSE. IF YOU ARE AN INSTRUCTIONAL YOU SHOULDN'T GLAZE OVER STEPS LIKE THIS
Do you have the sheet in front of you? If not, grab it, look over it and redo this video. ABC's comes RIGHT after the life threats and level of consciousness. You're wrong. "You have to follow the order of the NREMT trauma assessment sheet". That's correct, and the way this was done IS WRONG.
Rallypoint EMS NREMT Demos I don't think that's the case... I was always taught that you always check for ABC's after verbal and painful stimuli don't work unless you see life-threatening bleeding, in which case you treat that first.
My exam is on Friday 13, 2024 this is a very good video
This video is a great help. Thank you guys for this.
I understand you are following the NREMT skillsheet however if this was a real life scenario your patient probably died because you failed to immediately check for an exit wound after treating the GSW to the chest.
Hi Baker. This isn't a real-life scenario though so we are not considering that. Every GSW is different. I've had many with no exit wounds. I've had a few that have exited. If it exits out the lower leg what are your considerations? Do you need a four-sided occlusive or do you just bandage it? Remember, every call is different. I had a patient who was shot with a 45 in the abdomen and the bullet ended up logged in his lower jaw. It wasn't noticeable to us or other providers on scene. Do a good assessment, manage any life threats and monitor and address the ABC;s. Worry about the rest later.
RallypointEMS\Jeremiah
I still vote check for exit wound. If the smaller entry wound gets you’re attention then the larger exit wound should get some love too.
If you chart “entrance” or “exit” even if you are certain, instead of “open wounds” one of these days you may get called into court and asked how you knew for certain. Something like that could get a bad guy released or an innocent person incarcerated. Unless you have a degree in pathology, projectile dynamics or are board certified in forensic science, you should not chart those terms.
Agreed. Still should check for an exit even in training. Anyone knows relying on what you have seen before can get you fucked. Every call is different, so check all your bases.
@@fireemscraftsman2016 oşıl,
Is this rapid trauma assessment? LIke if done in real time it would only take two or so minutes?
really helpful, I'm currently taking my EMT course
Thank you. Glad to hear! Good luck in class!
Rallypoint EMS/Jeremiah
Same
Im refreshing my state but have been off the road so this is helpful. Thanks obv i have my protocols but ofc still super helpful on the order
Wait he took a blood pressure during primary assessment? Isn’t that a critical fail?
not at all
Only not correcting any life threatening injuries, protecting the airway airway and transporting at the appropriating time is critical fails on this station.
WRONG CRITICAL FAILS ALSO INCLUDE NOT STABILIZING C-SPINE, NOT CHECKING YOUR ABCS (WHICH HE DIDNT DO), AND NOT FOLLOWING THE ORDER OF THE EXAM WHICH WOULD PROLONG YOUR ON SCENE TIME AND BE A CRITICAL FAIL SO......
Why are you so heated by this
Le Foxy not a fail but v/s are on the secondary assessment
Good shit bro good fu@$ing job. Well done. It's like you were telling the proctor what to do.
Just curious why you inserted an OPA when the airway was patent?
I think a different angle would be more helpful
I needed a refresher for this
isn't he delaying transport by doing the second assessment on scene? that all should be done enroute.
He requested ALS transport.
SupaMonkey get in the road and tier. He has a penetrating injury with unresponsiveness. He needs an OR
Very professional, thank you!
Shouldn't stabilizing C-spine be done right after requesting ALS? And shouldn't back boarding and transport be done after the calculated GCS? I have my practical test this week and Im so confused on how to do this because we have been taught that for the test you have to follow word for word on the sheet for it? I really do enjoy your site, it has really helped me with studying.
Hi! Yes manual c-spine immobilization is done right after requesting ALS. I believe I had my partner do it in the video. Technically, you would board and transport the patient after determining your GCS. In the video I verbalize my rapid transport by saying my patient is a "high priority transport based on a GCS of three" at the 3 min 05 sec mark. That is sufficient enough you don't have to get nuts with packaging your patient. I want to see my students do the trauma skill station, not mess around with the backboard. Did you know there is actually a backboarding skill station?
One thing to keep in mind is that you are being graded on your ability to perform this whole skill. I doesn't make sense to strap the patient to the board and then later try to check his back while he's strapped to the backboard. (We don't keep patient's strapped to backboards during transport anyway because they do more harm to the spine than good.)
You absolutely do not need to follow the sheet word for word. We don't want you to be robots! This isn't realistic anyway because different scenarios and injuries are going to require you to do things a little differently.
Even though we may do it a little differently, I recommend you perform the skill as you have practiced in class. I'm sure you'll do just fine. Nervous is good, it means you want it! So be confident and go get it!
Thanks for watching!
Rallypoint EMS/Jeremiah
National Registry of Emergency Medical Technicians
Advanced Level Psychomotor Examination
PATIENT ASSESSMENT - TRAUMA
Candidate: ___________________________________________________________ Examiner: __________________________________________________
Date: ________________________________________________________________ Signature: __________________________________________________
Scenario # __________
Actual Time Started: __________ NOTE: Areas denoted by “**” may be integrated within sequence of primary survey
Takes or verbalizes appropriate PPE precautions 1
SCENE SIZE-UP
Determines the scene/situation is safe 1
Determines the mechanism of injury/nature of illness 1
Determines the number of patients 1
Requests additional help if necessary 1
Considers stabilization of spine 1
PRIMARY SURVEY/RESUSCITATION
Verbalizes general impression of the patient 1
Determines responsiveness/level of consciousness 1
Determines chief complaint/apparent life-threats 1
Airway
-Opens and assesses airway (1 point) -Inserts adjunct as indicated (1 point) 2
Breathing
-Assess breathing (1 point)
-Assures adequate ventilation (1 point) 4
-Initiates appropriate oxygen therapy (1 point)
-Manages any injury which may compromise breathing/ventilation (1 point)
Circulation
-Checks pulse (1point)
-Assess skin [either skin color, temperature, or condition] (1 point) 4
-Assesses for and controls major bleeding if present (1 point)
-Initiates shock management (1 point)
Identifies priority patients/makes transport decision based upon calculated GCS 1
HISTORY TAKING
Obtains, or directs assistant to obtain, baseline vital signs 1
Attempts to obtain SAMPLE history 1
SECONDARY ASSESSMENT
Head
-Inspects mouth**, nose**, and assesses facial area (1 point)
-Inspects and palpates scalp and ears (1 point) 3
-Assesses eyes for PERRL** (1 point)
Neck**
-Checks position of trachea (1 point)
-Checks jugular veins (1 point) 3
-Palpates cervical spine (1 point) Chest**
-Inspects chest (1 point)
-Palpates chest (1 point) 3
-Auscultates chest (1 point)
Abdomen/pelvis**
-Inspects and palpates abdomen (1 point)
-Assesses pelvis (1 point) 3
-Verbalizes assessment of genitalia/perineum as needed (1 point)
Lower extremities**
-Inspects, palpates, and assesses motor, sensory, and distal circulatory functions (1 point/leg) 2
Upper extremities
-Inspects, palpates, and assesses motor, sensory, and distal circulatory functions (1 point/arm) 2
Posterior thorax, lumbar, and buttocks**
-Inspects and palpates posterior thorax (1 point) 2
-Inspects and palpates lumbar and buttocks area (1 point)
Manages secondary injuries and wounds appropriately 1
Reassesses patient 1
Actual Time Ended: __________ TOTAL 42
CRITICAL CRITERIA
____ Failure to initiate or call for transport of the patient within 10 minute time limit
____ Failure to take or verbalize appropriate PPE precautions
____ Failure to determine scene safety
____ Failure to assess for and provide spinal protection when indicated
____ Failure to voice and ultimately provide high concentration of oxygen
____ Failure to assess/provide adequate ventilation
____ Failure to find or appropriately manage problems associated with airway, breathing, hemorrhage or shock [hypoperfusion]
____ Failure to differentiate patient’s need for immediate transportation versus continued assessment/treatment at the scene
____ Does other detailed history or physical exam before assessing/treating threats to airway, breathing, and circulation
____ Failure to manage the patient as a competent EMT
____ Exhibits unacceptable affect with patient or other personnel
____ Uses or orders a dangerous or inappropriate intervention
You must factually document your rationale for checking any of the above critical items on the reverse side of this form
Very good brother, respect from Canada🇨🇦🖒
I never heard of a transport decision. I did hear how long you would reassess the pt but never C-2 or C-3 to the closest trauma center??
Would he had been wrong if he address the airway before any apparent life threats?
Yes, you have to address apparent life threats first.
This is a slight exaggeration, but if the dude was on fire, would anything else on the sheet matter? You wouldn't be worried about his airway you would want to put the fire out. Same deal with other life-threats. If he's bleeding out from an artery you want to fix that first then worry about his breathing.
THE LIFE THREAT WASN'T APPARENT UNTIL YOU CONTINUE WITH YOUR HEAD TO TOE WHICH IS IN THE SECONDARY ASSESSMENT. YOUR PRIMARY ASSESSMENT IF DONE CORRECTLY WOULD HAVE INSPECTED THE AIRWAY AND BREATHING WITH WOULD HAVE SHOWN DIMINISHED LUNGS ON ONE SIDE OR NO BREATHING OR PARADOXICAL MOTION OR EVEN JVD WHICH WOULD THEN FORMULATE YOUR DIFFERENTIAL DIAGNOSIS YOU WOULD USE TO POINT YOU INTO THE DIRECTION OF INSPECTION OF THE CHEST AND UNCOVER THE TRAUMATIC PNEUMOTHORAX.
THIS WOULD ONLY BE A LIFE THREAT YOU WOULD CHECK FIRST IF YOU SAY FLAIL SEGMENT THROUGH THE SHIRT OR AN AMOUNT OF BLOOD LOSS OUTSIDE THE BODY THAT DOESN'T SUPPORT LIFE.
DO NOT MISINFORM FUTURE HEALTHCARE PROVIDERS THAT MAY ONE DAY HAVE SOMEONES LIFE IN THEIR HANDS
Jordan Parton....to be clear, you’re telling me a sucking chest wound is not an apparent life threat? Last time I checked it was. If I find a hole in the chest I’m going to treat it immediately so that it does not progress into a tension pneumothorax. (As a reminder, tracheal deviation and JVD are ominous and late signs.). The purpose of the primary assessment is to identify and treat immediate life threats. This is exactly what was depicted in the video. Similarly, if the EMT were to discover an arterial bleed it would be managed right away. They wouldn’t wait until they checked the extremities during the “secondary assessment.” I appreciate your feedback, but my video and remarks are not misleading. Let me know if you need me to cite additional sources.
www.emsreference.com/articles/article/tension-pneumothorax-0
books.google.com/books?id=UqEuDwAAQBAJ&pg=PA1801&lpg=PA1801&dq=jvd+is+a+late+sign&source=bl&ots=gyVDAoCDFn&sig=fOzNh-e71kdkkOwWx7-EShpI8zI&hl=en&sa=X&ved=2ahUKEwjs86r15IbbAhUBON8KHdLuAKMQ6AEwCHoECAQQAQ#v=onepage&q=jvd%20is%20a%20late%20sign&f=false
www.sjgov.org/ems/pdf/policies/5504_bls_primary_patient_assessment_draft.pdf
quizlet.com/62167023/emt-chapter-11-the-primary-assessment-flash-cards/
www.armystudyguide.com/content/powerpoint/First_Aid_Presentations/apply-a-dressing-to-an-op-5.shtml
emt.emszone.com/docs/CH27_AEC_Table.pdf
Sucking chest wound would be and I stated that in my comment. My statement is that you bypassed ABC! you wouldn't notice a "Sucking chest wound" without inspecting under the clothes which in real life could be getting you pt trauma naked which you wouldn't do until after checking ABCs. Instead of being an arrogant EMT take advise from the multiple experienced MEDICS and Helivac RNs trying to inform you that you are and will continue to be wrong with this I know everything because I make videos attitude.
Rallypoint EMS NREMT Demos
you know what good luck sir on your journey into ems. I’ll just make sure I’m I don’t get hurt or heaven forbid choke on something if I’m ever in your agency’s district. Again Good luck to you and all your patients 👍🏼
Wouldn’t he failed because he didn’t check for an exit wound in the rapid assessment?
Very interesting to watch the American version. Some things I’d do in a different order but I haven’t looked at the skills assessment sheet but do get every service, certifying company and instructor has a way you need to follow during testing. Like most things the stuff we learn on the road or with further training adopts to our regular patient assessment and routine that doesn’t lean to far off the path but close enough to make more efficient for us as the responder. Now this was done in 2017, not to sure if the laws have changed for our friends down south regarding boarding and other tools we use on the road. If it did, would be interested in seeing how it changed for American standards. Regardless cool video. As this is training though and a video, I get why there wasn’t as much in depth of some of the tasks. Maybe next time set up the lifepac (if you have them) if it’s part of the curriculum, or strap them in to the board. It lets others that haven’t seen it or look for that to see it right. Otherwise nice video! Keep it up
Wait how is he putting the cervical collar after he load and go???? Asking for a friend
Edit he didn't place him on a long board to transport ?????
Ps no disrespect I am really nervous for my exams checking everything to the T
The audio in this video is too low.
I've got my volume up to 100 % and I can barely hear these guys.
i can upload the video from another view and enhance the audio if that helps.
Rallypoint EMS/Jeremiah
New video posted
Vic Krue it’s just ur phone buddy
5 min in and just realized it was a dummy 😳
How come they decided to put in an OPA when the proctor confirmed the patient’s airway was patent?
Because the patient is unresponsive
Gotta control that tongue
just because its currently patent doesnt mean the tongue wont move and block the airway. the the opa prevents that from happening especially with ventilations.
Wouldn’t a BVM give him a tension pneumothorax if he was a gun shot wound to the chest?
I believe only if he has a punctured lung that forces air into the pleural space. And the occlusive dressing is used to have any extra air leak out of the open side.
The 3 sided occlusive dressing acts as a flutter valve. It allows for the positive pressure air via BVM to escape that chest cavity but on exhalation the valve seals itself not letting any air get sucked in with the negative pressure. Normally its negative pressure on inhale and positive on exhale, but with an open chest wound the roles swap. Therefore to answer your question, no it wouldn't cause a tension pneumothorax as the three sided occlusive dressing is preventing that from happening.
Maybe this isn't on the skill sheet, but in a real life situation you would want to roll the patient and check for an exit wound right away, because why would you let him sit there with a possible second hole in his chest until the end of your secondary assessment.
Dave that is correct. Roll right away because it is an immediate life threat.
Correct. That's what I am taught in my EMT-B course.
Rude chic walking in. “ oh excuse me while I cough and interrupt your video “
Everyone wants to be the star of the show!
Rallypoint EMS NREMT Demos true
LOOOOOOL
Why on earth would nremt have you make sure the patient is even alive halfway through the assessment...
When would put a cervical collar on? Wouldnt that be after ABCs?
After you have done your DCAPBTLS on the neck I'm pretty sure.
was that hesitation when he said "secondary" because he should have done it before vitals?
Humberto Duenas vitals come before secondary after transport decision on the nremt skill sheet
So, how much lead time do you need before you could come take my national registry exams for me?
I'm going to need the name of that supermodel and her room number first.
Jeez my scenarios are much harder. You have to actually do these things like EVERYTHING mentioned instead of just verbalized.
Make sure to document as necessary, he probably needs to get to the hospital and calling for als did not help your transport ti.e
Like a boss! Great job.
Thank you from this video
Dude, what about a possible exit wound? EVERY intervention would've failed.
Sorry, but wouldn’t ABCs be done first?
Pretty good but never leave the shoulder on the log role so we have been taught
Good training video and also you guys are cuties! 😁
Awesome!!
Can barely hear y'all.
My exam is Saturday good luck to everyone .
Not to add to the picking that most are doing, but I would add a radio report, because it’s now requirement. Just a suggestion. :)
Good shit.
load and goooo ;)
yeah no i’m gonna fail this
14 Guage past the 3rd rib anybody
👏🏼👌🏼
Great job dude , but U missed the following points
sample history
GCS
Log roll
Priority of transportation
Hey, qusai alrwashdeh, he mentioned that he would send his partner for Sample History, he called out transport priority along with a GCS of 3 and he log rolled to check the back then place the patient on the backboard.
I want to say he hit all the points you mentioned; but, let me know if I may have misunderstood your comment.
Thank you for your comments, i'll talk a look!
RallypointEMS\Jeremiah
***This video is intended for cookbook EMT’s only***
No glasses.. fail
FARMER DAVE!
הם נראים מאוד מוסריים
You didn't fill your reservoir bag! N00b
Not all bags have a reservoir on the end Daveeee......or do they??? Let me know.
THE BAG YOU ARE USING DOES SO HE SHOULD HAVE FILLED. ANOTHER MISS
Another miss.... What was my first miss???
look at my other comments.
Why would u fill the reservoir if it's not hook to a O2 supply??
Doing my national practical exam tonight
How’d it go?
@@japanesemythology5499 Very good, thanks! I’ve been work as an EMT for 7 months now
Romulo Chiaramonte Congratulations. I wish I could be an EMT. Lol. But my health won’t let me. I hope you live your job, you’ve got this
A sucking chest would is for three or more runs cracked on the same section and it is obvious
It ain't worth it
Or is this bullsit
Save your money. Be a nurse
worst haircut ive ever seen
I really hope you guys don't use this method in the field
In the field you may do things in a different order based on the presentation of your patient but every point he hit from the nremt trauma skill sheet you will hit in the field